Nallesairaala apuna lievittämässä sydänsairaiden lasten sairaalapelkoja

Suomessa syntyy joka vuosi noin 500 sydänsairasta lasta. Tavallisin sydämen rakennepoikkeavuus on kammioväliseinän aukko. Yli puolet sydänvikaisista lapsista tarvitsee yhden tai useamman sydänleikkauksen jo lapsuusiässä. Lapsille tehdään vuosittain noin 330 sydänleikkausta Helsingin yliopistollisen keskussairaalan lastenklinikalla. Opinnäytetyö oli toiminnallinen ja se tehtiin yhteistyössä Sydänlapset ja – aikuiset ry:n kanssa. Työn tarkoituksena oli selvittää kyselyn avulla 3-9-vuotiaiden sydänsairaiden lasten (N=9) sairaalapelkoja. Lisäksi selvitettiin lasten pelkoja yleisesti, sekä niihin liittyviä selviytymiskeinoja. Tavoitteena oli lievittää sydänsairaiden lasten pelkoja heille tehtäviä tutkimuksia ja hoitotoimenpiteitä kohtaan Nallesairaala toimipisteen avulla. Opinnäytetyötä ohjaavat kysymykset olivat mistä sydänsairaan lapsen hoitotyö koostuu, miten lapsen kehitys eroaa sydänsairaan lapsen kehityksestä, mitä asioita lapset sekä sydänsairaat lapset pelkäävät sairaalassa ja millaisten selviytymiskeinojen avulla lasten sairaalapelkoja voidaan lievittää. Lasten pelkoja ja niihin liittyviä selviytymiskeinoja selvitettiin kirjallisuuden ja tutkimusten pohjalta. Sydänsairaiden lasten sairaalapeloista saatiin tietoa kyselyn avulla. Vastaukset avattiin sanalliseen muotoon. Ne analysoitiin kysymysten mukaan, jokainen kysymys erikseen. Tulokset vahvistivat asioita, joita myös tiedonhaun pohjalta saatiin lasten pelkoihin liittyen. Tuloksina saatiin, että lapsen ja sydänsairaan lapsen ajattelussa ja psykososiaalisessa kehityksessä, eikä heidän kokemissaan sairaalapeloissa ole juurikaan eroa. Pelot jaettiin toimenpiteisiin-, sairaalaympäristöön- ja lapseen itseensä kohdistuviin pelkoihin. Lapset tarvitsevat kognitiivisia, emotionaalisia, ja toimintokeskeisiä selviytymisstrategioita hallitakseen sairaalaan liittyviä pelkoja. Jatkossa tulisi arvioida Nallesairaalan toimivuutta pelkojen lievittämiskeinona uuden kyselyn avulla. Lisäksi olisi mahdollista tehdä uusi kysely sydänsairaille lapsille, jossa olisi suurempi vastaajien määrä. Tulosten pohjalta saataisiin lisää tietoa sydänsairaille lapsille kohdistettavista sairaalapelkojen hallintakeinoista.Approximately 500 cardiac diseased children are annually born in Finland. The most common structural abnormality is ventricular septal defect. Over half of the cardiac diseased children need one or more cardiac operations already at childhood age. Approximately 330 cardiac operations are annually conducted at the children’s clinic of Helsinki academic central hospital. This thesis was operational and it was conducted in co-operation with Sydänlapset ja –aikuiset association. The objective was to sort out hospital fears of 3-9 year old child cardiac patients. In addition, the children's fears in general and ways of coping with them were also surveyed. The objective was to alleviate the fears children have on examinations and treatment procedures conducted on them upon the help of Teddy bear hospital. Directing questions of the thesis were what does the nursing of child cardiac patient consist of, how a child's development differs from the development of a child cardiac patient, what are children and child cardiac patients fear in hospitals and with what kind of ways the hospital fears of children can be alleviated. The children's fears and related ways of coping with them were clarified on the basis of literature and researches. Information about child cardiac patients' hospital fears were surveyed with an enquiry. The answers were transfigured into verbal form. They were analyzed according to the questions, each question individually. The results confirmed issues about children's hospital fears, that were also found out from the retrieved information. The results implied that there isn't much difference in cerebration and psychosocial development between a child and a child cardiac patient, and also the hospital fears experienced do not differ much. The fears were divided in fears related to the procedure, to the hospital environment and to the children themselves. The children need cognitive, emotional and functional survival strategies in order to learn to control the fears related to the hospital. The functionality of Teddy bear hospital as a way of alleviating fears should be estimated with a new enquiry in the future. In addition, it would be possible to conduct a new enquiry to child cardiac patients covering a bigger amount of respondents. Based on results, more information on ways of controlling child cardiac patients' hospital fears could be obtained

Cutaneous T-Cell Lymphoma (CTCL) Cell Line-Derived Extracellular Vesicles Contain HERV-W-Encoded Fusogenic Syncytin-1

Non peer reviewe

Matrix metalloproteinase (MMP)-2, MMP-9, semen quality and sperm longevity in fractionated stallion semen

Matrix metalloproteinase (MMP)-2 and MMP-9 are gelatinases that take part in several reproductive processes. The aim of this study was to measure levels of MMP-2 and MMP-9 in fractionated stallion ejaculates, and to evaluate the association between these components and semen quality, and sperm longevity during cooled storage. Semen quality were assessed separately for sperm-rich fractions (HIGH), sperm-poor fractions (LOW), and whole ejaculate samples (WE) from 33 stallions. After cooled storage with SP either present or removed, sperm motility and DFI were determined. The relative activity of the pro-form of MMP-2, active MMP-2 and total MMP-9 were evaluated using gelatin zymography, and all were present in all fractions of the stallion's ejaculate, with higher relative activity of the latent than active forms and the highest relative activity in the HIGH fraction. The relative activities of MMP-2 and MMP-9 were positively correlated to sperm concentration and total sperm count, but only in the HIGH fraction and not in LOW or WE. The relative activities of MMPs were not related to differences in sperm longevity during cooled storage, measured as sperm motility and DFI. There was a harmful effect of SP on DFI during storage, but this effect was not associated with differences in the relative activities of MMPs. In conclusion, the relative activities of MMPs are not useful as markers for semen quality (other than sperm concentration), or sperm survival during storage in horses. (C) 2021 Elsevier Inc. All rights reserved.Peer reviewe

Syöpä muuttaa solunulkoisten vesikkelien metabolista sormenjälkeä

Cancer alters cell metabolism. How these changes are manifested in the metabolite cargo of cancer-derived extracellular vesicles (EVs) remains poorly understood. To explore these changes, EVs from prostate, cutaneous T-cell lymphoma (CTCL), colon cancer cell lines, and control EVs from their noncancerous counterparts were isolated by differential ultracentrifugation and analyzed by nanoparticle tracking analysis (NTA), electron microscopy (EM), Western blotting, and liquid chromatography-mass spectrometry (LC-MS). Although minor differences between the cancerous and non-cancerous cell-derived EVs were observed by NTA and Western blotting, the largest differences were detected in their metabolite cargo. Compared to EVs from noncancerous cells, cancer EVs contained elevated levels of soluble metabolites, e.g., amino acids and B vitamins. Two metabolites, proline and succinate, were elevated in the EV samples of all three cancer types. In addition, folate and creatinine were elevated in the EVs from prostate and CTCL cancer cell lines. In conclusion, we present the first evidence in vitro that the altered metabolism of different cancer cells is reflected in common metabolite changes in their EVs. These results warrant further studies on the significance and usability of this metabolic fingerprint in cancer.Peer reviewe

Biological and clinical significance of tryptophan-catabolizing enzymes in cutaneous T-cell lymphomas

Indoleamine 2,3-deoxygenase 1 (IDO1) induces immune tolerance in the tumor microenvironment (TME) and is recognized as a potential therapeutic target. We studied the expression of both IDO1 and the related tryptophan 2,3-dioxygenase (TDO) in several different subtypes of cutaneous T-cell lymphoma (CTCL), and evaluated the kynurenine (KYN) pathway in the local TME and in patient sera. Specimens from the total of 90 CTCL patients, including mycosis fungoides (MF, n = 37), lymphomatoid papulosis (LyP, n = 36), primary cutaneous anaplastic large cell lymphoma (pcALCL, n = 4), subcutaneous panniculitis-like T-cell lymphoma (SPTCL n = 13), and 10 patients with inflammatory lichen ruber planus (LRP), were analyzed by immunohistochemistry (IHC), immunofluorescence (IF), quantitative PCR, and/or liquid chromatography-tandem mass spectrometry (LC-MS/MS). Three CTCL cell lines also were studied. Expression of both IDO1 and TDO was upregulated in CTCL. In MF specimens and in the MF cell line MyLa2000, IDO1 expression exceeded that of TDO, whereas the opposite was true for LyP, ALCL, and corresponding Mac1/2A cell lines. The spectrum of IDO1-expressing cell types differed among CTCL subtypes and was reflected in the clinical behavior. In MF, SPTCL, and LyP, IDO1 was expressed by malignant cells and by CD33(+) myeloid-derived suppressor cells, whereas in SPTCL CD163(+) tumor-associated macrophages also expressed IDO1. Significantly elevated serum KYN/Trp ratios were found in patients with advanced stages of MF. Epacadostat, an IDO1 inhibitor, induced a clear decrease in KYN concentration in cell culture. These results show the importance of IDO1/TDO-induced immunosuppression in CTCL and emphasize its role as a new therapeutic target.Peer reviewe

Identification of Gut Microbial Lysine and Histidine Degradation and CYP-Dependent Metabolites as Biomarkers of Fatty Liver Disease

Peer reviewe

Cancer Alters the Metabolic Fingerprint of Extracellular Vesicles

Simple SummaryCancer changes cell metabolism. In this study, we explored if the metabolic rewiring also alters the metabolite content of cancer-derived extracellular vesicles (EVs). For this, metabolomes of EVs from different cancers (prostate, cutaneous T-cell lymphoma, and colon cancer cell lines) were compared with the metabolomes of control EVs derived from matched non-cancerous cell lines. The metabolomes of EVs from all three cancer types significantly differed from their respective control EVs by elevated levels of proline and succinate. Additionally, prostate and cutaneous T-cell lymphoma cell line -derived EVs contained elevated levels of creatinine and folate when compared to controls. In conclusion, this study presents the first evidence that a shared panel of metabolites in EVs reflects the altered metabolic state of multiple cancer cell types in vitro. These results warrant further studies of the significance and usability of a metabolic fingerprint in cancer studies and for biomarker discovery.Cancer alters cell metabolism. How these changes are manifested in the metabolite cargo of cancer-derived extracellular vesicles (EVs) remains poorly understood. To explore these changes, EVs from prostate, cutaneous T-cell lymphoma (CTCL), colon cancer cell lines, and control EVs from their noncancerous counterparts were isolated by differential ultracentrifugation and analyzed by nanoparticle tracking analysis (NTA), electron microscopy (EM), Western blotting, and liquid chromatography-mass spectrometry (LC-MS). Although minor differences between the cancerous and non-cancerous cell-derived EVs were observed by NTA and Western blotting, the largest differences were detected in their metabolite cargo. Compared to EVs from noncancerous cells, cancer EVs contained elevated levels of soluble metabolites, e.g., amino acids and B vitamins. Two metabolites, proline and succinate, were elevated in the EV samples of all three cancer types. In addition, folate and creatinine were elevated in the EVs from prostate and CTCL cancer cell lines. In conclusion, we present the first evidence in vitro that the altered metabolism of different cancer cells is reflected in common metabolite changes in their EVs. These results warrant further studies on the significance and usability of this metabolic fingerprint in cancer